肝脏局灶性病变患者实时剪切波超声弹性成像声像图特征及其诊断价值

Characteristics and diagnostic value of real-time shear wave ultrasonic elastography in patients with focal liver lesions

目的:分析肝脏局灶性病变(FLLs)患者实时剪切波超声弹性成像(SWE)声像图特征及其诊断价值。方法:回顾性分析102例FLLs患者的临床资料,患者均行SWE检查,根据病理结果分为良性病变组(n=45)及恶性病变组(n=57),恶性病变患者再根据分化程度分为低分化组(n=15)、中分化组(n=17)及高分化组(n=25),分析各组声像图特征,对比患者弹性模量平均值(E_(mean))、弹性比值(Eratio),分析二者的诊断价值及与分化程度的关系。结果:恶性病变组弹性图像填充颜色主要为红色。恶性病变组E_(mean)、Eratio均高于良性病变组(P<0.05);ROC曲线显示,E_(mean)、Eratio联合诊断FLLs良恶性病变的曲线下面积(AUC)高于二者单独诊断(P<0.05);低分化组E_(mean)、Eratio均高于中分化组和高分化组(P<0.05);Spearman分析显示,E_(mean)、Eratio与分化程度负相关(P<0.05)。结论:SWE可通过E_(mean)、Eratio定量评估FLLs病灶硬度信息,对FLLs诊断具有较高的价值。

Objective:To analyze the characteristics and diagnostic value of real-time shear wave ultrasonic elastography(SWE)in patients with focal liver lesions(FLLs).Methods:The clinical data of 102 patients with FLLs were retrospectively analyzed.All patients underwent SWE.According to pathological results,they were divided into benign lesion group(n=45)and malignant lesion group(n=57).According to differentiation degree,patients in malignant lesion group were divided into low differentiation group(n=15),medium differentiation group(n=17)and high differentiation group(n=25).SWE characteristics were analyzed in both groups.The mean elasticity modulus(E_(mean))and elasticity ratio(Eratio)in patients were compared.The diagnostic value of E_(mean)and Eratio,and their relationship with differentiation degree were analyzed.Results:The main filling color of elastic images was red in malignant lesion group.E_(mean)and Eratio in malignant lesion group were higher than those in benign lesion group(P<0.05).ROC curves analysis showed that AUC of E_(mean)combined with Eratio in the diagnosis of benign and malignant FLLs was greater than that of single index(P<0.05).E_(mean)and Eratio in low differentiation group were higher than those in medium differentiation group and high differentiation group(P<0.05).Spearman correlation analysis showed that E_(mean),Eratio were negatively correlated with differentiation degree(P<0.05).Conclusion:E_(mean)and Eratio by SWE can quantitatively evaluate lesion hardness information in FLLs patients,which have high diagnostic value for FLLs.